A few months ago, I was wrapping up a lengthy consultation, when my patient pulled out three pages of an "ask your plastic surgeon" questions she’d found on Google. I had other patients waiting, so I was about to direct her to my staff, when she posed this question: “Would you do surgery on a member of your family?” What a strange must-ask question, I thought. “No,” I said aloud. “Not major ...

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shutterstock_110328875 Time was baffling. It seemed like just yesterday; I sat in a posh auditorium in Chicago as an enthusiastic young adult during my first day of medical school orientation at Northwestern in 1995. Eighteen years later I was a forty-three-year-old burned out physician, practicing in Boise, Idaho, doing Google searches on the most effective way to end my life. During my time ...

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Being sick and hospitalized in a lonely and unfamiliar place is a terrifying time for our patients. It’s an easy thing for doctors and nurses to forget as we go about our hectic days, when time goes by so quickly that we barely have time to stop and think. Whether you are practicing medicine in a large academic center or a small rural hospital, the feedback that patients give about ...

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shutterstock_175398194 american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. I often hear patients say, “I am not afraid of the surgery, just the anesthesia.” But should patients worry?   Physician anesthesiologists suffered a crisis in confidence in 1982 when the ABC television program 20/20 aired, “The Deep Sleep:  6,000 ...

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asco-logoI’m sure I am not alone in saying that I am almost obsessively conscious of time. Namely, that there never seems to be enough of it. As busy oncologists, we all have constant demands on our time, from our leadership, colleagues, drug company reps, insurers, and our families, not to mention the time we try to carve out for ourselves. But ...

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I watched helplessly as a dear friend went through the emotional meat grinder of a new cancer diagnosis. Her husband was found to have melanoma on a recent skin biopsy, and she knew that this was a dangerous disease. Because she is exceptionally intelligent and diligent, she set out to optimize his outcome with good information and the best care possible. Without much help from me, she located the finest ...

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"To be trusted is a greater compliment than to be loved." - George MacDonald As we adjust her position on the surgical table, I spot some short, vertical scars on the front of her neck. The parallel slashes sit directly over her enlarged thyroid -- a goiter -- and appear to have been deliberately placed. There are two sets of scratches, one set on either side of the neck, nearly identical in length and evenly ...

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shutterstock_155241647 “So you’re a Rhodes Scholar, and you’re just a family doctor?” If I was paid a dollar each time I’m asked this question, I can safely retire. It seems innocent enough, and it’s usually asked without malice. But the fundamental assumption behind this question alarms me: that family doctors are somehow less competent and less valuable to society than specialist doctors. It’s an ...

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Patients want to receive health care that is of the highest quality. Physicians want to provide it. But what is “high-quality health care?” On that, few agree. Ask most Americans and they’re unsure where to find it. They know they want to be kept healthy, have rapid access to personalized care whenever they need it and be charged only what they can afford. Ask the leaders of the national medical and surgical ...

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“Hi, it’s Dr. Smith, are you taking consults today?” the voice on the other side of my short-range hospital phone said.  I recognized the caller's name as one of the new hospital doctors, known as hospitalists. “Of course,” I said, “What have you got?” I guess some groups have a specific doctor for the day “take” the consults.  If I am in the hospital, I am always taking consults. “Great,” the hospitalist ...

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